Side Loading Articulating Laryngeal Access System

ABSTRACT

A laryngeal access system includes a laryngeal blade with a proximal portion and a distal portion, an inner channel extending longitudinally through the laryngeal blade, wherein an outer wall of the laryngeal blade has an opening therethrough extending from the proximal portion to the distal portion of the blade through which an object can pass through the outer wall into the inner channel, an articulating member provided at the distal portion of the blade, and an actuator provided at the proximal portion of the blade and coupled to the articulating member, wherein the actuator moves the articulating member from a first position, in which the articulating member has a first longitudinal axis, to a second position, in which the articulating member extends at an angle relative to the first longitudinal axis.

FIELD OF THE INVENTION

The invention relates to a medical intubation device, and morespecifically, to a side loading articulating laryngeal access system forperforming intubation procedures.

BACKGROUND OF THE INVENTION

In critically injured, ill or anesthetized patients, it is oftennecessary to insert an endotracheal tube into a person's airway tofacilitate ventilation of the lungs and to prevent the possibility ofasphyxiation or airway obstruction. The most common routes of insertingthe endotracheal tube are oral, in which the tube is passed through themouth and larynx into the trachea, and nasal, wherein the tube is passedthrough the nose and larynx into the trachea.

The insertion of the endotracheal tube often involves serious risks,such as damage to the vocal cords and a prolonged intubation procedurein which the patients breathing is stopped, but oxygen is not yetdelivered to the patient as the tube has not yet been inserted. It isestimated that about one third of deaths occurring during a surgicalprocedure while under anesthesia for morbidly obese patients areassociated with the intubation process. Some of the difficulties thatpersons performing endotracheal intubation encounter include therestriction of view as the tube is inserted, variations in the anatomyof the patients, an uncomfortable and unnatural position of the personperforming the procedure while holding the instrument, and the necessityfor rapid intubation.

With the advent of various video devices and cameras, instrumentationhas been improved to the extent that it can enable viewing of the cordsand larynx on a video screen thereby facilitating the intubation of thepatient in a relatively quick and safe manner. However, the knownimaging intubation devices still suffer from a number of disadvantagesand drawbacks.

For example, with the current systems, the intubation is typicallyaccomplished by inserting a rigid laryngeal blade into a person'strachea, and then inserting an endotracheal tube alongside the blade.Such rigid laryngeal blades are pre-shaped to have a certain curvaturegenerally corresponding to the curvature of a person's airway passageanatomy. However, different types of patients often have differentanatomies and it may be challenging to use the rigid blade for differenttypes of patients because the blade's shape cannot be easily adjusted tofit the anatomy of a particular patient, particularly at the distal endof the blade.

Additionally, because the current systems require separate insertion ofthe laryngeal blade and the endotracheal tube, they require significanttime to set up and to insert into the patient. In emergent situationsthis delay could be hazardous, if not deadly.

Another major problem with current systems is the limited field of view,requiring more time for the user to intubate the patient. Typically, theimaging device is positioned at a distal tip of the device body whichonly provides a limited view of the surrounding tissue, even if thedistal tip is capable of being angled to a certain degree.

What is desired, therefore, is an improved system and method forintubating a patient that address the disadvantages and shortcoming ofthe prior art systems described above.

SUMMARY OF THE INVENTION

It is therefore desired to provide an improved laryngeal access systemthat can be easily adjusted to fit anatomy of different types ofpatients.

It is further desired to provide an improved laryngeal access systemwith components that can be quickly and easily assembled to facilitateemergent intubation of a patient.

It is also desired to provide an improved laryngeal access system thatprovides the user with a greater field of view to facilitate a quickerintubation and reduce the probably of injuring the patient.

It is yet further desired to provide an improved laryngeal access systemthat provides enhanced and more efficient user control during theintubation process.

In order to achieve at least the above-mentioned objects of the presentinvention, a laryngeal access system is provided including a laryngealblade with a proximal portion and a distal portion, an inner channelextending longitudinally through the laryngeal blade, wherein an outerwall of the laryngeal blade has an opening therethrough extending fromthe proximal portion to the distal portion of the blade through which anobject can pass through the outer wall into the inner channel, anarticulating member provided at the distal portion of the blade, and anactuator provided at the proximal portion of the blade and coupled tothe articulating member, wherein the actuator moves the articulatingmember from a first position, in which the articulating member has afirst longitudinal axis, to a second position, in which the articulatingmember extends at an angle relative to the first longitudinal axis.

In certain embodiments, an inner wall of the blade has at least oneprotrusion extending into the channel and configured to movably grip anobject positioned in the inner channel.

In some embodiments, the actuator moves the articulating member from thefirst position to the second position in response to application ofpressure thereto by a user's hand.

In certain embodiments, the actuator is activated by a lineardisplacement of the actuator by a user's finger. In additionalembodiments, the actuator is activated by a rotational movement of theactuator by a user's finger.

In some embodiments, the actuator is coupled to the articulating membervia a wire.

In certain embodiments, the system further includes an imaging devicemovably disposed in the inner channel. In some of these embodiments, theimaging device includes at least one of a CMOS device and a CCD device.In additional embodiments, the imaging device includes at least oneillumination device generating light for illuminating surroundingtissue.

In some embodiments, a portion of the laryngeal blade proximal to thedistal end of the blade is substantially flexible such that it bendswhen the articulating member is moved to a second position.

In certain embodiments, at least a portion of the laryngeal blade issubstantially transparent to allow for imaging of surrounding tissuethrough the blade.

In some embodiments, the articulating member comprises an imaging devicedisposed thereon. In certain of these embodiments, the articulatingmember further includes an illumination device positioned adjacent theimaging device.

In certain embodiments, the laryngeal blade includes at least one sensorpositioned thereon. In some of these embodiments, the at least onesensor includes at least one of a pulse oximetry sensor, a bloodpressure sensor, a temperature sensor, a flow sensor and a biofilmsensor.

In some embodiments, the laryngeal access system further includes anendotracheal tube removably accommodated in the inner channel via theopening and having a lumen. In certain of these embodiments, theendotracheal tube includes an inflatable balloon positioned adjacent adistal end of the endotracheal tube.

In certain embodiments, the laryngeal system further includes a fluidsource coupled to the inflatable balloon via an inflation lumen providedin the endotracheal tube.

Other objects of the invention and its particular features andadvantages will become more apparent from consideration of the followingdrawings and accompanying detailed description.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a front perspective view of the laryngeal access system inaccordance with the present invention.

FIG. 1B is a front perspective view of another embodiment of thelaryngeal access system in accordance with the present invention.

FIG. 2 is a rear perspective view of the laryngeal access system of FIG.1A.

FIG. 3 is an enlarged partially cross-sectional front perspective viewof a distal portion of the laryngeal access system of FIG. 1A.

FIG. 4 is a partially cross-sectional front perspective view of anendotracheal tube of the laryngeal access system of FIG. 1A.

FIGS. 5A and 5B are cross-sectional views of the endotracheal tube ofFIG. 4 taken along the lines “A-A” and “B-B” respectively.

FIG. 6 is a front perspective view of an imaging device of the laryngealaccess system of FIG. 1A.

FIG. 7 is an exploded view of the camera of the imaging device of FIG.6.

FIGS. 8A and 8B are partially cross-sectional view of an imaging styletused with the laryngeal access system of FIG. 1A.

DETAILED DESCRIPTION OF THE INVENTION

The basic components of one embodiment of a laryngeal access system inaccordance with the invention are illustrated in FIG. 1A. As used in thedescription, the terms “top,” “bottom,” “above,” “below,” “over,”“under,” “above,” “beneath,” “on top,” “underneath,” “up,” “down,”“upper,” “lower,” “front,” “rear,” “back,” “forward” and “backward”refer to the objects referenced when in the orientation illustrated inthe drawings, which orientation is not necessary for achieving theobjects of the invention.

As shown in FIG. 1A, the laryngeal access system (10) includes alaryngeal blade or cannula (12). In some embodiments, the blade (12) ismade with any suitable rigid or semi-rigid material, such as, e.g.,metal or polymer, and is pre-shaped to correspond to the anatomy of aperson's throat and trachea. In other embodiments, the blade (12) may bemade with malleable material, such that the blade can be bent into adesired shape right before the intubation procedure to more preciselycorrespond to the anatomy of the patient undergoing intubation. Forexample, children's trachea anatomy differs from that of an adult andthe shape of the laryngeal blade may need to be adjusted to accommodateintubation of pediatric patients.

The blade (12) has a hollow interior connected to a distal end openingand a proximal end opening. The hollow interior accommodates variousinstruments and devices necessary for the intubation procedure, such asan endotracheal tube and an imaging device, as described in more detailbelow.

The laryngeal blade (12) also includes an articulating member (18)positioned above the distal end opening, as shown in FIG. 1A. Thearticulating member (18) is capable of articulating to different anglesof deflection in all directions, as well as performing rotationalarticulation. The articulation of the member (18) assists a physicianperforming an intubation in safely and efficiently accessing thesubject's trachea anatomy to deflect various structures, e.g., thesubject's tongue, to position the blade inside the subject's trachea.

The articulation of the member (18) is performed via an actuatorpositioned at the proximal end of the blade (12) and coupled to thearticulating member (18). Various suitable actuator types may be used inaccordance with the present invention. In the embodiment illustrated inFIG. 1A, the actuator is pressure based. In other words, the physicianperforming the intubation procedure applies pressure to a hand grip (20)provided at the proximal end of the blade (12) by squeezing the handgrip. The application of pressure translates to the articulation of themember (18) of the blade.

In other embodiments, such as shown in FIG. 1B, the member (18) isarticulated by a linear, e.g., horizontal, vertical or diagonal, orrotational displacement of the actuator by the physician's finger. Theactuator is in the form of a button or a joystick (21) provided on theouter surface of the proximal portion of the blade opposite the handgrip (22). This positioning makes it convenient for the physician to usehis or her thumb to actuate the button (21). It is understood that inother embodiments, the actuator (21) may be provided on the hand gripportion (22) or at any other convenient location on the proximal portionof the blade (12).

In additional embodiments, the actuator may be in the form of a handlewith a pistol-type grip and a trigger-type lever having a closed loopinto which a user may insert a finger. In further embodiments, theactuator may be a button that slides in a channel provided in the wallof the proximal portion of the blade (12). The linear displacement ofthe button within the channel is transmitted to the articulating member(18) via any mechanisms described below to deflect the member (18).

The actuator (21) is coupled to one or more wires (23) that connect theactuator with the articulating member (18) to enable movement of themember (18). The wires (23) are connected to the actuator (21) through atransmission box (27) that translates movement of the actuator by theuse into movement of the wires and the articulating member (18). Inadditional embodiments, piezoelectric or pneumatic mechanism or atensioning skin may be used in place of the wires (23) to enableactuation of the articulating member (18). The actuator (21) moves thearticulating member (18) from a first position in which the member (18)has a first longitudinal axis X to a second position, in which themember (18) has a second longitudinal axis Y that is angularly offsetfrom the first axis X at an angle alpha (α).

The articulating member (18) is coupled to the blade (12) via anysuitable connection that allows for deflection of the member (18). Insome embodiments, a flexible collar (25) connects the articulatingmember (18) to the distal portion of the blade (12). In additionalembodiments, the section of the blade (12) proximal to the articulatingmember (18) is sufficiently flexible such that it will also bend to adegree when the member (18) is articulated.

The laryngeal blade (12) further includes a side-loading channel (22)extending along the blade, as illustrated in FIG. 1. The channel (22)has an opening on one side that extends longitudinally along a length ofthe channel (22). The channel (22) is designed to receive variousinstruments, i.e., an endotracheal tube and/or an imaging device, to bepositioned inside the blade (12). The side-loading channel (22) allowsfor one-hand use of the system (10) during the intubation procedure.Additionally, this design allows for the endotracheal tube and/or theimaging device to be inserted into the subject's throat and tracheainside the blade (12) as opposed to the traditional side-by-sideinsertion, which requires more space and can be more complicated andtraumatic to the patient.

The side loading channel (22) includes one or more pairs ofcorresponding protrusions (38). The protrusions (38) assist inmaintaining an endotracheal tube and/or the imaging device in a fixed orstabilized position inside the channel (22). The protrusions (38) may bepositioned at any desired location within the channel (22). It isunderstood, however, that the protrusions (38) still allow for linear(back and forth) displacement of the endotracheal tube and/or imagingdevice inside the side channel (22) of the blade (12). The protrusions(38) are made with any material that has a suitable coefficient offriction that allows for fixation and relative movement of theendotracheal tube/imaging device inside the blade (12).

In some embodiments, as shown in FIG. 3, the laryngeal blade (12)includes an imaging device (17) positioned on the articulating member(18). Any suitable known imaging device may be used in accordance withthe invention. The imaging device (17) assists the physician performingthe intubation procedure in imaging a patient's anatomy for faster andless traumatic intubation. The imaging device (17) may be moved todifferent angles by articulating the member (18) to provide differentangles of view of the patient's anatomy. In additional embodiments, thelaryngeal blade (12) further includes one or more sources ofillumination (19), such as LEDs or optical fibers, for illumination oftracheal anatomy during the intubation procedure. The illuminationdevices (19) may be used with or without the imaging device (17).

In some embodiments, the laryngeal blade (12) includes one or moresensors positioned thereon. The sensors are positioned at the distalportion of the blade or in any other desirable location along the blade.The sensors may include a pulse oximetry sensor, a blood pressuresensor, a temperature sensor, a flow sensor and/or a biofilm sensor. Thesensors provide various information to the physician that may be usefulduring and after the intubation procedure. For example, it may bedesirable to measure oxygen saturation in the patient's body, or measurethe patient's body temperature without having to use a separate deviceto obtain the measurement.

The system (10) also includes an endotracheal tube (“ET tube”) (14). TheET tube (14) is inserted into a subject's trachea to establish andmaintain a patent airway and to ensure an adequate exchange of oxygenand carbon dioxide. The ET tube (14) is made with any suitable materialthat is flexible enough to conform to the person's tracheal anatomy. Thetube includes an opening at its distal end for allowing air to flowthrough an inner lumen (32) of the tube and also to allow for insertionof various instruments through the tube, e.g., an imaging device, tofacilitate the intubation procedure.

One exemplary embodiment of the ET tube (14) is illustrated in FIGS. 4and 5A-5B. As shown in FIG. 4, the ET tube (14) includes an inflatableballoon (30) positioned adjacent the distal end opening. In thisembodiment, the ET tube (14) includes an inflation lumen (34) forsupplying inflation fluid to the balloon (30) from a fluid source (26),which is shown in FIG. 1. Any suitable fluid source may be used, such asa hand-held pump or an electromagnetic pump to supply fluid to theinflatable balloon (30). It is also contemplated that, in alternativeembodiments, the fluid source may be an integral part of the ET tube(14). The inflation lumen (34) is provided with any suitable connector,such as a luer connector, for connection to the fluid source (26).

As shown in FIGS. 5A and 5B, the inflation lumen (34) is separate fromthe inner lumen (32). This allows for inflation of the balloon (30)without compromising the passage of air through the inner lumen (32) topatient's lungs. The inflation lumen (34) may be positioned around theinner lumen (32), as shown in these figures. In other embodiments, theinner lumen (32) and the inflation lumen (34) may be positioned side byside in the ET tube (12).

The fluid source supplies a fluid, such as a gas, liquid, or mixturethereof, to the inflatable balloon (30) to inflate it. The inflationlumen (34) has one or more openings (33) positioned inside the balloon(30) to allow flow of inflation fluid to the balloon from the fluidsource (26). The fluid source, i.e. a pump, may also include a varietyof capabilities for balloon identification, proper inflation/deflationof the balloon, and feedback measurements, many details of which aredescribed in U.S. Pat. No. 8,226,601 to Gunday et al. In certainadvantageous embodiments, the fluid source (26) further includes avacuum source to evacuate fluid from the balloon (30) to assist infaster deflation of the balloon.

The inflatable balloon (30) may be made of latex, Yulex, polyethylene,nylon or other suitable material, and may come in a variety of sizes anddiameters, depending on a particular type of patient being intubated.The balloon (30) is attached to the outer wall of the ET tube (14) atits distal and proximal ends via any suitable method, such as via anadhesive.

In some embodiments, the balloon (30) has a wall with a textured outersurface that provides a gripping surface to facilitate anchoring theballoon (30) on the patient's airway passage. The textured outer surfaceof the balloon (30) may be formed by a fiber mesh affixed to the surfaceof the balloon during the molding process. The fiber mesh may be made ofelastane, latex, lycra, polyurethane, nylon, nylon coated with othermaterials such as cotton, composite springs, or other appropriatematerial. In other embodiments, dimensional surface structures orinflatable sinuses that are encapsulated in the surface substrate of theballoon (30) may be used to produce the textured surface.

The system (10) further includes an imaging device (16), one exemplaryembodiment of which is illustrated in FIG. 6. The imaging device (16)has an elongated shaft with a distal end (42) and a proximal end (44).The shaft is made with any suitable rigid or semi-rigid material thatcan conform to the shape of the ET tube (14) and/or the laryngeal blade(12). In some embodiments, the imaging device (16) has an articulatingdistal portion that can be bent to different angles to provide for abetter visualization of the surrounding anatomy. Any of the actuatingmechanisms described above may be positioned at a proximal end of theimaging device and used to articulate the imaging device.

The imaging device (16) may comprise any imaging device suitable forviewing the target area, such as a coherent fiber bundle or appropriateoptical element and lens assembly in conjunction with an imaging sensor(e.g., CMOS, CCD), having a sufficiently small outer diameter,preferably about 0.75 mm-2.5 mm, and more preferably about 1 mm or less.

In some embodiments, there is a camera head positioned at the distal end(42) of the shaft. The camera head can have any suitable design. One ofthe exemplary embodiments of the camera head is illustrated in FIG. 7.The camera head (50) includes a camera housing (51) that houses allcamera components. The housing (51) is made with any suitable material,such as plastic or metal, and has any desired shape and size. The cameraalso includes one or more lens positioned in the housing. In theembodiment shown in these figures, the camera includes two plano-convexlenses (54) and (55) positioned opposite of each other such that theconvex sides of the lenses are facing each other. It is understood thatany other lens type and arrangement may be used in accordance with thepresent invention, as desired.

The camera head (50) further includes an imaging sensor (56) positionedproximally from the lens (54) and (55). Any type of imaging sensor maybe used. The imaging sensor (56) is coupled a sensor mount (57) tofixate the sensor inside the housing. In one advantageous embodiment, aCMOS sensor is used. The housing (51) also has one or more illuminationdevices (53), e.g. LEDs, lasers, and/or fiber optic cables, positioneddistally from the lens. It is understood than other types ofillumination devices may be used. Furthermore, illumination devices thatare separate from the camera may also be utilized in accordance with thepresent invention.

The illumination devices emit various types of light, depending ondesired application. For example, the illumination devices may emitambient light, visible spectrum light, ultraviolet light, infraredlight, near infrared light, etc. A distal end of the housing (51) has ascreen or cover (52) that seals the distal end of the housing to protectthe camera components positioned in the housing.

It is understood that the camera design illustrated in the above figuresis only exemplary and that any other camera head design may be used withthe system of the present invention.

In certain embodiments, the laryngeal access system (10) furtherincludes a storage device (not shown), which is provided to store, forexample, the image data captured by the imaging device (16). The storagedevice may comprise virtually any type of storage device and may beinternal or external to the system (10). For example, suitable storagedevices include a magnetic, high density hard drive, a writable mediumincluding a CD/DVD, or a card inserted into the screen casing including,for example, a removable drive, such as a thumb drive, volatile ornon-volatile memory, etc.

In some embodiments, the laryngeal access system (10) is coupled to aprocessor for receiving and processing image data captured by theimaging device (16) and/or the imaging device (17) positioned on theblade (12). Any suitable type of a processor may be used. The system(10) is connected to the processor via a cable connection, which maycomprise, for example, an optical channel and a data channel.Alternatively, it is understood that the system (10) may be wirelesslycoupled to the processor via a network connection. It is contemplatedthat network connection may comprise, for example, an Internetconnection.

The processor may be coupled to a remote storage, which may comprisevirtually any type of memory device, as described above. Additionally,virtually any type of digital data may be saved on remote storage, suchas, but not limited to, configuration data, update information, imagedata, etc. The processor is further connected to a display via a cableor wireless connection, for displaying the processed image data to theuser. The display may be any suitable type of display, such as acomputer monitor or a television screen.

It is noted, however, that in some embodiments, the image data generatedby the imaging device (16) or (17) may also be processed by a controldevice positioned on the blade (12). In such embodiments, the processedimage data may then be transmitted from the control device to theprocessor via cable or wirelessly. The processor is then used to furtherprocess the information and/or transmit the image data to the display.

The connection coupling the laryngeal access system (10) to theprocessor (10) can include a two-way communication. For example, inaddition to the imaging data captured by the imaging device (16) or(17), the system (10) may transmit other information, such as, forexample, identification/use/maintenance data, to the processor. Theprocessor may then use this information to automatically configure tofunction properly with the system (10). Additionally, command andcontrol data may be transmitted to the system (10) from the processor,which may include commands for moving the imaging device (16) orarticulating the blade (12). In such embodiments, an input device, suchas keyboard, mouse, track pad, microphone, etc., may be coupled to theprocessor and used by a user to provide input commands for the system(10). It is further contemplated that, rather than having a separateinput device, the display may be provided as a touch screen controldevice, which may be used to both display image data and provide forcontrol/command inputs.

The laryngeal access system (10) may include a power cable for providingelectrical power to the electronics and illuminating devices, orelectrical power may be provided via battery power (such as arechargeable battery) positioned on the blade (12) or removablyconnected to the blade. Alternatively, it is contemplated that thesystem (10) may be wirelessly powered via any known coupling devices.

In additional embodiments, the imaging device (16) is in a form of animaging stylet, such as described in the U.S. Publication No.2014/0275778 to Gunday et al., the disclosure of which is incorporatedherein in its entirety, and illustrated in FIGS. 8A and 8B.

The imaging stylet (60) includes an outer housing (62) and an opening(64) provided at a distal end of the housing. The outer housing (62) ismade of any suitable malleable material, such as polyether block amidematerial (Pebax®), which preferably has a low modulus of elasticity withminimized resistance to bending. The outer diameter of the outer housing(62) should usually be made as small as possible. Typically, the outerdiameter is less than about 5 mm. Preferably, the outer diameter of thecatheter body is less than 3 mm.

In some embodiments, the outer housing (62) is an extruded cylindricalmember having at least three inner lumens that accommodate variouscomponents of the imaging stylet (60), as described in more detailbelow. It is understood, however, that any other suitablestructure/configuration of the outer housing (62) may be utilized inaccordance with the present invention.

The imaging stylet (60) also includes a support member (66) disposedwithin the outer housing (62). The support member (66) is preferably asolid rod having a cup-shaped portion at its distal end. The supportmember (66) is constructed with any suitable malleable semi-rigidmaterial, such as aluminum, that is capable of being bent to a certainshape and also being capable of retaining that bent shape. Before use,the support member (66) is first bent to a certain angulation thatcorresponds to a shape of larynx and trachea of a particular patientbeing intubated. The support member provides rigidity to the flexibleouter housing to facilitate the intubation process.

An imaging device (68) is further disposed in the outer housing (62),preferably via an imaging device lumen. The imaging device includes animaging device head (76) positioned adjacent the opening (64) at thedistal end (78) of the outer housing (62). Any suitable type of imagingdevice may be used in accordance with the present invention. In oneexemplary embodiment, the imaging device (68) is a camera provided witha fiber optic image bundle (74) introduced through the imaging devicelumen of the outer housing via a port provided at the proximal end toimage the surrounding area. The fiber optic image bundle may be made ofcoherent imaging fibers at the core, and a lens provided at the distalend of the camera head. The camera may incorporate various types ofobject lenses at the distal tip for different fields of view (i.e. 50°,130°, etc.) and various depths of field. At the proximal end of thefiber optic bundle, the coherent imaging fibers may be interfaced to anysuitable type of digital imaging device, including, but not limited to,a CMOS device or a CCD.

In some advantageous embodiments, the imaging device (68) furtherincludes at least one illumination device for illuminating surroundingtissue during the intubation process. For example, the imaging devicemay include one or more light emitting diodes positioned around thecamera lens. It should be noted, however, that other sources ofillumination may also be employed. For example, in other embodiments,two separate bundles, one for illumination and the other for image canalso be used. Similarly to the cohered fibers, the illumination fibersare interfaced to a light source. It should also be noted that the imagesensor can be located at the distal end of the imaging device head,eliminating the need for a coherent imaging fiber bundle, thusincreasing the image quality and reducing cost.

The imaging device head (76) is attached to a distal end of the supportmember (66) by a resilient member (70). The resilient member (70) ismade with any type of suitable material that returns to its originalform after being deformed. In one advantageous embodiment, the resilientmember (70) is a leaf-spring.

The imaging device head (76) is further connected to an actuator (72)disposed in an actuation lumen of the outer housing (62). The actuator(72) may be a push/pull wire, a distal end of which is connected to theimaging device head (76) and a proximal end of which is coupled to acontrol device provided at the proximal end of the outer housing (62).

In its inactivated position, the imaging device head (76) is alignedwith the longitudinal axis of the distal end (78) of the outer housing(62) such that it lays flat on the cup-shaped distal portion of thesupport member (66). When the push/pull wire (72) is pulled by the uservia the control device, the imaging device head (76) is brought from itsinactivated position to an activated position, wherein it extends out ofthe opening (64) in the outer housing (62) at a certain angle relativeto the longitudinal axis of the housing, as shown in the figure above.The angle at which the imaging device (76) extends out of the outerhousing (62) may be adjusted as desired to facilitate viewing of thepatient's larynx and trachea anatomy during the intubation process toensure that the patient's vocal cords or other internal structures arenot damaged. In some advantageous embodiments, the angle is in the rangeof from about five degrees to about forty degrees. If desired, theimaging stylet (60) can also be rotated via the control device such thatother sides of the patient's airway passage may be viewed as well.Thereby, the intubation system of the present invention allows for acomplete 360 degree visualization of the airway passage anatomy. Itshould be noted that any other type of actuation device may also be usedto actuate the imaging device (76) in accordance with the presentinvention.

Image data collected by the imaging device (16) is transmitted to aprocessor coupled thereto either wirelessly or via a cable connection.The image data is processed and displayed to the user via a displaycoupled to the processor.

Referring back to the first figure above, before the intubationprocedure is commenced, the imaging device (16) is inserted into the ETtube (14) via the port (24). The ET tube (14) is then slid into thelaryngeal blade (12) via the side-loading channel (22) such that theimaging device head is positioned at the distal end of the blade (12)and the proximal section of the ET tube (14) extends out of the opening(28) at the proximal end of the blade (12). The blade is then insertedinto a patient's mouth. The blade actuator portion (20) is grasped bythe physician and the blade is advanced into the person's trachea, whilethe distal deflecting portion (18) of the blade is actuated to conformto the person's anatomy and facilitate atraumatic insertion of theblade. At the same time, the imaging device (16) is used to provideillumination and visualization of the tracheal anatomy to furtherfacilitate the insertion process. All of this may be accomplished via aone-hand approach.

Once the blade (12) is positioned at the desired site inside theperson's trachea, the blade is slid off the ET tube (14) via theside-loading channel (22) and is withdrawn from the person's trachea andthroat. The balloon (30) on the tube (14) is inflated via the fluidsource (26) such that it grips the surrounding tissue to fixate the ETtube (14) inside the person's trachea. The imaging device (16) may thenbe withdrawn from the ET tube (14) and the tube is connected to arespiratory device to assist the person's breathing.

It should be understood that the foregoing is illustrative and notlimiting, and that obvious modifications may be made by those skilled inthe art without departing from the spirit of the invention. Although theinvention has been described with reference to embodiments herein, thoseembodiments do not limit the scope of the invention.

What is claimed is:
 1. A laryngeal access system, comprising: alaryngeal blade with a proximal portion and a distal portion; an innerchannel extending longitudinally through the laryngeal blade; wherein anouter wall of the laryngeal blade has an opening therethrough extendingfrom the proximal portion to the distal portion of the blade throughwhich an object can pass through the outer wall into the inner channel;an articulating member provided at the distal portion of the blade; andan actuator provided at the proximal portion of the blade and coupled tothe articulating member, wherein the actuator moves the articulatingmember from a first position, in which the articulating member has afirst longitudinal axis, to a second position, in which the articulatingmember extends at an angle relative to the first longitudinal axis. 2.The laryngeal access system of claim 1, wherein an inner wall of theblade comprises at least one protrusion extending into the channel andconfigured to movably grip an object positioned in the inner channel. 3.The laryngeal access system of claim 1, wherein the actuator moves thearticulating member from the first position to the second position inresponse to application of pressure thereto by a user's hand.
 4. Thelaryngeal access system of claim 1, wherein the actuator is activated bya linear displacement of the actuator by a user's finger.
 5. Thelaryngeal access system of claim 1, wherein the actuator is activated bya rotational movement of the actuator by a user's finger.
 6. Thelaryngeal access system of claim 1, wherein the actuator is coupled tothe articulating member via a wire.
 7. The laryngeal access system ofclaim 1, further comprising an imaging device movably disposed in theinner channel.
 8. The laryngeal access system of claim 7, wherein saidimaging device comprises at least one of a CMOS device and a CCD device.9. The laryngeal access system of claim 7, wherein said imaging devicecomprises at least one illumination device generating light forilluminating surrounding tissue.
 10. The laryngeal access system ofclaim 1, wherein a portion of the laryngeal blade proximal to the distalend of the blade is substantially flexible such that it bends when thearticulating member is moved to a second position.
 11. The laryngealaccess system of claim 1, wherein at least a portion of the laryngealblade is substantially transparent to allow for imaging of surroundingtissue through the blade.
 12. The laryngeal access system of claim 1,wherein the articulating member comprises an imaging device disposedthereon.
 13. The laryngeal access system of claim 12, wherein thearticulating member further comprises an illumination device positionedadjacent the imaging device.
 14. The laryngeal access system of claim 1,wherein the laryngeal blade comprises at least one sensor positionedthereon.
 15. The laryngeal access system of claim 14, wherein the atleast one sensor comprises at least one of a pulse oximetry sensor, ablood pressure sensor, a temperature sensor, a flow sensor and a biofilmsensor.
 16. The laryngeal access system of claim 1, further comprisingan endotracheal tube removably accommodated in the inner channel via theopening and having a lumen.
 17. The laryngeal access system of claim 16,wherein the endotracheal tube comprises an inflatable balloon positionedadjacent a distal end of the endotracheal tube.
 18. The laryngeal accesssystem of claim 16, further comprising a fluid source coupled to theinflatable balloon via an inflation lumen provided in the endotrachealtube.